Treatments for Disseminated Intravascular Coagulation (DIC) in the Japanese Guidelines for the Management of Sepsis

DOI
  • Aibiki Mayuki
    Ehime University, Graduate School of Medicine, Department of Emergency and Critical Care Medicine
  • Umakoshi Kensuke
    Ehime University, Graduate School of Medicine, Department of Emergency and Critical Care Medicine
  • Kikuchi Satoshi
    Ehime University, Graduate School of Medicine, Department of Emergency and Critical Care Medicine
  • Matsumoto Hironori
    Ehime University, Graduate School of Medicine, Department of Emergency and Critical Care Medicine
  • Ohshita Muneaki
    Ehime University, Graduate School of Medicine, Department of Emergency and Critical Care Medicine
  • Takeba Jun
    Ehime University, Graduate School of Medicine, Department of Emergency and Critical Care Medicine

Bibliographic Information

Other Title
  • 日本版敗血症診療ガイドラインにおけるDIC（Disseminated Intravascular Coagulation）治療

Search this article

Description

The Japanese guidelines for the management of sepsis include “Japan-limited treatments and procedures” such as anti-coagulatory therapy, which were not addressed in the Surviving Sepsis Campaign Guidelines 2012. In this section, we describe septic DIC, which could be a cause of multiple organ failure resulting from production of intravascular micro-thrombi. Treatments for DIC need to firstly cope with the etiological disease, however, the anti-coagulatory therapy could be effective for improving the survival from severe sepsis with DIC. As an agent for DIC, AT (anti-thrombin) is modestly recommended: although a large scale random clinical trial (RCT) could not improve the survival rates in septic patients, several subgroup analyses have shown improved outcomes. rhTM (recombinant human thrombomodulin) is fairly recommended, since this agent aided recovery from DIC better from severe sepsis as compared to unfractionated heparin, which was followed by several clinical studies showing the benefits of rh-TM in septic DIC. A recent Japanese National Sepsis Registry showed a possible better improvement in survival rate in severe sepsis as compared to those of other countries, which might facilitate further studies regarding the anti-coagulatory treatment for severe sepsis with DIC.

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top